Current Republican campaign strategy is to scare the electorate with the assertion that a Biden victory would turn us into a Socialist nation, including a Sanders style “Medicare for All” plan that would eliminate the private insurance industry. That’s crazy talk, illustrating Trump’s desperation. Let’s calm down and take a look at reality.
The American economy is what economists refer to as a “mixed system,” basically capitalism, with government stepping in where the private sector falls short.
Affordable healthcare for all is a goal that is not, and cannot be, achieved through unfettered profit-maximizing private insurance. Even the youngest and healthiest of individuals will one day require health care, the expenses for which could not be profitably covered by profit-maximizing insurers.
Thanks to the popular and successful government program, Medicare, the problem of insuring seniors has been partially resolved. With a significant share of medical expenses of seniors covered through Medicare, private insurers can compete for supplementary plans.
Many people in the workforce are covered by employer-sponsored health plans. But this leaves many people not covered at all, including those with pre-existing conditions for whom private insurance is not available at affordable prices. President Obama promised to address this problem upon his election in 2008.
People without health insurance either remained untreated or visited emergency rooms. One would like to believe that all Americans and responsible politicians would have seen this as a moral issue, and joined in the humane goal of addressing this issue. Instead, affordable healthcare for all was, and remains, one of the most contentious and divisive issues of our time.
At its best, politics is the art of the possible. At worst, politics is solely about accumulation of power — power above solution of problems. Upon Obama’s election, Senate Majority Leader McConnell immediately practiced politics at its worst, expressing the goal of “making President Obama a one-term president.” That meant stopping Obama from achieving his signature campaign promise of making affordable healthcare available to all.
Obama’s basic approach was to center the program on the existing system of private provision of health care, and privately sponsored health insurance.
Opposition to government involvement in making affordable health care available to all was fierce. Republicans resorted to scare tactics including charges that “seniors would lose their Medicare,” “death panels would determine who lives and who dies,” and this was “a total government takeover of healthcare.”
To the contrary, with the exception of the Veterans Administration and the military, health care would continue to be provided by the private sector. With the exception of Medicare and Medicaid for the poor, insurance would still be provided through private insurers. But to make it financially feasible for private insurers to cover those with pre-existing conditions at affordable rates, there had to be a mandate that young and healthy individuals also be insured. That’s the way insurance works — broaden the pool and spread the risk. Without the mandate, the plan would not be financially feasible.
The Affordable Care Act was signed into law in March 2010, as the most comprehensive reform to health care in the U.S. since Medicare in 1965.
If politicians who enjoyed government-sponsored health insurance were hypocritical, it was also a very low period for the mainstream media, including NPR. Pundits and anchors repeated infinitum the false charges of ACA opponents. With the troubled rollout of the program, H&HS Secretary, Kathleen Sebelius, was mercilessly trashed by the media.
For Democratic efforts to address this long-standing problem for low income and working-class people, they were hammered over three election cycles, beginning with the debacle of 2010. National surveys showed widespread opposition to the program. But were there any surveys of people who needed, and were benefitting from, the program? Were there any significant media interviews of people who were benefitting from the program, and enjoying medical care for the first times in their lives? Of course not — unfortunate people without health insurance remained invisible to the media.
Yes, opposition to the ACA was news. But so were, and are, the consequences of large numbers of low income people without healthcare. Is it too cynical to suggest that the well-insured electronic commercial media pundits and the worthies of NPR simply could not identify with low-income people who faced such a dilemma? The low income beneficiaries of the ACA remained essentially invisible — until 2017.
The Senate for the umpteenth time was voting to end the ACA. The Trump/McConnell/ Republican goal to eliminate the ACA appeared a cinch to pass the Senate. But whaddaya know — beneficiaries suddenly appeared out of nowhere. Media pundits appeared shocked that millions of people benefitted from the once-despised ACA. With the insistence and pleading of beneficiaries, Republican Senators Murkowski, Collins, and McCain famously voted against repeal. That’s nice, but where were they when it would have taken political courage to work with President Obama to make affordable health care available?
In 2012, the US Supreme Court, to the dismay of conservatives, had narrowly paved the way for implementation of the ACA. But President Trump still holds the elimination of the ACA as a major goal. He held its possible — likely? — repeal by the Supreme Court as a major factor in his nomination of Justice Barrett who had criticized the Court’s 2012 decision.
This brings us to Trump’s desperate rant that Biden has been “captured” by the Democrats who want “Medicare for All,” virtually eliminating the role of private insurance companies.
Forget it — a Sanders version of “Medicare for All” won’t happen — can’t happen — even if Democrats take the White House and the Senate. With the trashing the Democrats took from the Republicans, the media, and even much of the public for attempting to achieve a humane goal, there is zero, zilch, nada, chance that such a bill will land on Biden’s desk.
Medicare for those who want it and can buy into it is another story, and a possibility, should Biden win and Democrats take over the Senate. However, given our history, even that will be a heavy lift.
— John Waelti’s column appears every Saturday in the Times. He can be reached at jjwaelti1@tds.net.
